Fever management

Written by Charmaine Dennis, Naturopath

Often a fever is mistaken as foe, and quickly controlled with Paracetamol. It is important to realise that a fever is actually one of the body’s mechanisms to fight an invasion (ie the real enemy -a virus or bacterium that has invaded primary defences). It is a good sign that the body’s vital force is working acutely to ward off an infection so it does not progress. It is far more beneficial to manage a fever than suppress it.

A fever is generally preceded by chilliness, sometimes shivering (to increase the body’s temperature), headache and a weak feeling in the limbs. In the hot stage, the skin feels dry and hot to touch, heart rate is increased and there is often excessive thirst and no appetite. Normal temperature is considered to be between 36-38 degrees celcius, moderate fever 38-39.5 degrees celcius , high fever over 39.5 degrees celcius.

Elevated body temperature has important functions:

1. It mobilises the immune system into action – white blood cells multiply far more rapidly when the temperature is higher than the normal range. Killer T-cells are increased, as are neutrophils and macrophages, which are the white blood cells responsible for destroying invaders. At the same time, tissue-repairers like fibroblasts and collagen are formed at an increased rate.
2. It inhibits pathogens – viruses and bacteria multiply at normal temperature, and their growth is inhibited by higher temperatures.
3. It clears waste from the tissues, lymph and blood, on which bacteria feed and multiply.

While paracetamol may bring the fever down for a while, it does not assist in the germ-fighting process, and sometimes leads to complications. Suppressing the fever actually prevents the body from destroying the pathogen.

Many parents are nervous about letting their baby or child ‘run’ a fever in case of febrile convulsions. These are very rare, related to a rapid rise in temperature rather than a high temperature. While frightening to witness, they are rarely harmful.

Steps to take to ensure the best response to fever

• Work out what temperature you feel comfortable to manage at home (often in the middle of the night! Research before the next fever!)
• Monitor your child’s temperature regularly, and keep a record to see where the temperature is going – every ½-1 hour is appropriate in moderate to high fevers

Under the tongue is most accurate

Adjust temps taken under the arm by adding 0.5 degrees celcius for accuracy

Rectal temperatures are unnecessary

• Keep your child warm, dressed fully but lightly and away from any drafts or wind.
• Stay indoors and cuddles, quiet play, books, rest, sleep, light meals are the activities for the day.
• Most importantly, keep the fluids up with water, herbal teas, chicken broths and breast milk if appropriate. No cold drinks – lowering the temperature this way only makes the body work harder to raise it again. Diluted, sugar-free electrolyte drinks, alternating with water may be of use to prevent dehydration.
• Use herbal teas such as lime blossom (tillia) or cat nip; they encourage a fever to break (see below).
• If your child’s appetite is diminished, there is no need to worry; his/her body is putting energy into healing, not digestion. Fluids are the most appropriate thing to consume at this stage.
• Do not give cold drinks, undress, apply cold sponges or put your child into a cold bath or shower.
• No sugar in any form including fruit juice or honey as it can reduce the immune response for up to 5 hours. If it assists compliance, small amounts of Manuka honey in the herbal tea would be OK, as Manuka has been shown to improve the immune response.
• Stay calm with your child. Any undue stress will rise the temperature further

Sweating is the sign that the fever has broken, and your child will usually rest peacefully at this stage.

When a fever does go too high

If your child’s fever is reaching up to or above your comfort zone for management, there are further steps you can take before reaching for medication to suppress it. As a guide, intervene only if the temperature is over 38.3 degrees celcius in an infant, 39.4 degrees celcius in a child (and 40 degrees celcius in an adult)

• Apply a cool (not cold) compress to the head.
• Sponging with tepid (normal body temperature) water of the face, arms, chest and neck or run a tepid bath – full immersion is best. A child must be held at all times and never left alone in the bath (you may need to hop in depending on the age of the child), so a third person is helpful for monitoring the bath temperature. Take the temperature regularly while in the bath and stop when the temperature is at a safe level. If shivering occurs, stop the treatment immediately and wrap the child up warmly. Shivering will increase the temperature again and is best avoided.
• Homoeopathics are very useful at this stage, and it is helpful to have a few first aid remedies for fever management picked out in advance. Ask your practitioner for help with this.

Herbal Teas

Herbal teas should be given regularly at all stages of fever and can be the main fluid consumed. Lime Blossom is the herb of choice for treating childhood fever. It induces sweating and is relaxing to the nervous system, encouraging rest and sleep. It can also help to alleviate headache. Catnip is another with similar effect to lime blossom, but also has an action of calming an upset digestive system. Combine with herbs such as lemon balm for viral infections, elder for mucus congestion, peppermint for nausea and taste

Paracetamol

Only reach for paracetamol if the temperature stays too high for more than two hours in an infant, or six hours in a child, in spite of natural interventionist methods. Assess whether you need to use the dose that gets the temp down to normal level or if just enough to take the edge off a high fever is appropriate. This would allow the benefits of an elevated temperature to continue.

If you have any concern about your child’s condition sometimes it is appropriate to call your doctor or local hospital, or utilise services such as Nurse On Call for advice before attending hospital. Often lengthy waits in cold waiting rooms will make things worse. If you do deicide to make the trip to hospital, make sure you take warm blankets, a pillow, plenty of herbal tea, room temperature water and patience!

You can manage most fevers at home, but your doctor should be called if:

• The temperature reaches higher than you are comfortable managing
• Your child seems dehydrated, does not respond to you, is not able to stop crying or becomes pale or mottled-looking.
• He or she has symptoms such as ear pain, painful urination or any unusual severe pain.
• Your child seems sicker to you than you would expect with a cold or flu.
• Fever lasts more than two days.

Any fever over 40 degrees celcius or showing symptoms of breathing difficulties, convulsions, turning blue around the lips or vomiting, is to be regarded seriously and medical advice should be sought.

There is no doubt that parenting through a fever with out medication is not the easy way. You do have to be more alert, monitoring regularly and prepared to spend the night cuddling your child for a closer watch. Allowing your child to experience a fever that naturally resolves will, in most circumstances, strengthen his/her immune system, reducing the length of infection and preventing reoccurrence.

At Fertile Ground Health Group all of our naturopaths can give advice and treat a wide range of health conditions. Our resident specialist for children and family naturopathic appointments is Sarah Harris who is a qualified and experienced naturopath with a special interest in children and family health. Being a mother of three beautiful children, she has a wealth of personal experience managing health and illness in kids. Sarah works with families to find solutions for all manner of health conditions, providing practical knowledge, testing where applicable, dietary advice, and herbal and nutritional medicines.